Job Description
Job Description
This position will lead the Pharmacy reporting, analytics, and forecasting for the Commercial Business. The primary responsibility of this role is to be the liaison between the CVS PBM and the Commercial Business and to lead the financial functions in finance to support Pharmacy products
Build and Maintain a Comprehensive Rx Management Process
* Work with multiple organizations and interpret complex, incomplete, and inconsistent data using analytical skills to refine raw information into actionable financial data for use by executive management
* Align the process with the HCB Actuarial and Underwriting teams to ensure budgets, forecasts, and monthly analytics are informed by pricing, claim, and utilization drivers. Maintain and adjust the process for changes in pricing, methods, and other business changes
* Promote a continuous improvement environment where the Rx management process is constantly scrutinized for improvements in efficiency and accuracy
* Drive analysis down to case level data to not only inform pricing decisions but also to become a partner with sales to promote more accurate and competitive offerings to drive business growth
Monthly Reporting and Analytics
* Continuous monitoring of results to identify trends in Rx usage and work to coordinate action plans to ensure HCB formularies are designed to minimize member benefit costs and maximize CVS results while maintaining the highest level of care.
* Collaborate with others to develop the business story with minimal time in a fast paced environment.
* Have a strong understanding of the overall financial process for Rx
* Compile, analyze, and present large amounts of data in a concise and clear manner that allows for effective communication with Executive Management
Forecast/Budget
* Collaborate with actuarial and underwriting to ensure accurate forecasting.
* Work with CVS PBM to ensure appropriate data is received and verify data for accuracy.
* Manage the forecast process ensuring the data received for forecasts and budgets is appropriately disseminated to our forecasting systems.
* Drive improvements to the forecast and budget outlook by working with all business partners.
Analytics
* Understand the key drivers associated with Rx costs in Risk funded products
* Provide analysis for ASC funded rebates and fee spread
Special Projects - There are a number of requests that this role with have to manage that are complex. This will be a challenging role that bridges accounting, finance, actuarial, underwriting, and business operations.
Pay Range
The typical pay range for this role is:
Minimum: 75,400
Maximum: 158,300
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
-8+ years of accounting, financial, actuarial, and/or underwriting work experience
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
Knowledge of:
* Rx Products and PBM functions
* Healthcare Business
* Healthcare pricing practices
* Advanced actuarial concepts
* Transfer pricing
Skill in:
* Advanced computer skills (Access, Hyperion, S4/HANNA, Hyperion, Tableau, Alteryx, VBA)
* Synthesizing large amounts of data into executive level analytical materials
* Building and managing data processes
Ability To:
* Negotiate best outcomes with business partners including Actuarial, U/W, and the CVS PBM
* Influence pricing decisions in the best interest of HBC and CVS
-Experience working cross functionally
-Experience with process/project managment
Education
Bachelor Degree or equivalent experience requirement
Advanced Degree, Masters or MBA preferred
Concentration in Accounting, Finance, or Actuarial preferred
Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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